As a serious answer:
I thought about how well I live. As a life-long computer programmer, I don't think I make an extraordinary amount but I live in a nice house in Berkeley Heights and work in NJ. BH just recently made the list of the top 6 number of places to live.
So, one wage earner, 40 hour week, nice home, all the food I want. How could I complain about "crushing" taxes?
Ah, you replied to an idiot. He went in my KF a long time ago.
Anyway, I'm living in the 6th best community in the USA. Money magazine says so. (Yep Berkeley Heights just moved up the list and we're all bragging about it.)
I have American relatives by marriage who have lived and worked in Canada. The older one and his wife recently retired to the USA but made sure to become Canadian citizens before doing so, so that if faced with high-cost medical treatment in the USA they can always return to Canada for low-cost or even free treatment.
The younger one laments the high cost of health insurance in the USA and reminds us of the paltry cost of her pregnancies and deliveries in Canada -- not to mention the paid pregnancy and maternity leave.
A while back I saw a TV program about Americans going to Thailand for surgery by US-trained surgeons for a small fraction of US costs.
Perce
I am sorry, but to me this essentially boils down to I want to tax people based on what does or does not offend me personally. While I understand the sentiment, this is a lousy way to make tax policy. If I misunderstood, please feel free to correct me (seriously).
While some docs take death personally and will keep it going, most of the time this is more related to family or others not wanting to let Granny go (or other similar personal reasons having little or nothing to do with Granny's needs and/or wishes). I have already told my kids that I want zapped once if indicated and needed prior to 70 because I think that is too early to go. After that, don't break my ribs or do other BS. (That would of course change based on health issues. I am assuming good health overall) However, I don't see a time anytime soon where we would accept actively killing granny.
>
Still serious? Okay. :)
In our town they set the tax rate in order to avoid a deficit. They aren't allowed a deficit and they aren't allowed to make large increases. It's a constant battle between providing services, good schools and holding the tax line.
This year they canceled spring bulk cleanup due to budget constraints.
I don't see any tax "policy" issue, they have certain constraints and certain expenditures they feel they must make.
But my comment was about "crushing" taxes.
I'm not a doctor, lawyer, CEO, or even executive. Yet I can live in one of NJ's nicest towns. I'm far from being crushed.
Sure taxes are higher than they are in the boondocks of Pennsylvania (I guess), but we make more too. I'm finding it entirely affordable.
Punative dammage awards are capped - if they even exist at all up here. Pain and suffering awards don't run into the millions like they do in the US. Doesn't matter if we're talking about medical matters or other stuff (product liability, etc).
Your legal system is killing your obstetrics and gynecological professions, making those doctors harder to come by.
Many hip replacements are done on an emergency basis. Old person falls, breaks hip, must be seen and fixed within 24 hours. Our system can handle those.
Elective knee and hip surgery is a moving target. Many people technically need them, few WANT to undergo the surgery, they put up with the pain and/or reduced mobility, so when they're scheduled for it they really don't care what the wait-time is.
The few that make noises about getting it done sooner (younger, more active, etc) get moved up the list and are seen in a reasonable time frame.
A friend's cousin opted for surgery and by the *seventh* revision she could no longer walk. She eventually became so despondent about the downward spiral that she took her own life.
Back surgery, IMHO, is highly overrated and over-recommended.
Lots of people (raises hand) get into back trouble through stress. I often wonder if the back isn't some sort of biological circuit breaker that trips when stress levels become intolerable? In my experience stress makes what might have been sore spot turn into a serious problem. Once the discs bulge and a nerve gets pinched, the downhill slide begins rapidly.
Yep. Many people just don't want to face "the end" sooner than they have to. Can't say I blame them, or know how I'll handle it. My old dog died Sunday. She was about 17 years old. Never been to the vet, and "healthy" until the end. A little slower getting up the last year or so, and gone deaf. Otherwise normal until about a half an hour before she died. Then she just stood in one place. But she didn't look worried. Looked normal standing there. I knew I would have to take her to be put down in the morning. I dreaded that. Because I would have to give the vet the nod. "Kill my dog." After about 10 minutes she slowly walked over to her hallway spot and laid down with her head on her paws. Did a little gasping, then rolled on her side, stretched out and whimpered for about 10 seconds. Then she was gone, her head in my wife's lap. She never looked more pretty. She lived fine, and died fine. Too bad all dogs and all people don't have the luck she did. It would make things a lot simpler.
Ever hear of repeating a grade? I haven?t in fifty years.
There are three subjects doctors know nothing about and should be
ignored when they pretend to: sex, diet and lower back pain.
Joel N. Shurkin on the NASW mailing list
A living will is so important, and the more discussion with family, the better. It is absolutely one's own choice to make and folks can save their families a lot of grief in making their wishes known. If they want to hang on through and and every crisis, it is a matter also for families to participate in assuring clear, informed choices are made.
My mom was essentially tortured to death with radiation, chemo and resulting complications at age 82....she didn't get any explanation (informed consent) of treatment for malignant brain tumor, glioblastoma, beyond the expected length of survival with or without treatment. The oncologist was more than happy to offer treatment, as was the radiologist. Treatment was interrupted to place a stent in coronary artery for anginal pain. When she returned to the neurosurgeon during treatment for a check, he remarked in a very surprised tone "You are receiving chemo?". Damn. The best she could have gotten at the time was 19 mos, vs. 6 without treatment. She never complained of headaches or any other symptoms of the tumor, and they are not solid tumors like those that cause increased pressure inside the skull. That was 20 years ago, and even now it is a more treatable tumor but still almost always fatal....it grows like the nerve cells do, spider like throughout the brain, so not much in the way of surgery. At time of her diagnosis, she was happy and very active. Don't know what doing nothing would have been like, but I suspect she would just have faded away.
Stress can bother a lot of systems, especially heart and immune sys. Backs? I dunno. Who doesn't have stress? I'd bet a majority of folks with bad backs are overweight and out of shape....obesity and a big belly change the way the back works entirely. Bulging discs come with age, and many are never a problem. I'm not harping on weight for folks who have organic bone and nerve problems! A lot of beginning disc problems, even ruptured discs, can be effectively resolved with physical therapy, exercise and weight control; but then, often enough they can be surgical emergencies.
I've had three seriously painful back injuries...one, bending over to clean the bath tub and two lifting patients. No physician treatment, just ice, then heat, and anti-inflam. The last one was probably a torn ligament, because the pain was not sore muscle. Doing fine now.
Dogs can be pretty noble creatures, and my family has been blessed in that regard. My son recently had his 16 y/o schnauzer euthanized...his boys were with them, Buster got special meals, and many long walks in the woods up to the end. He had a bad back for a few years and could no longer climb the special steps to get into bed with anyone :o) He walked a lot, and could make a circuit through the kitchen to dining room to living room to hall and would keep going round and round....instinct to keep from stiffening up? He never spent a day on a chain in the yard, was always walked for exercise and doing his jobs. If he dared to beg at the dinner table, it was just by laying his head on your knee....that was also his way of asking for some cuddling. When Buster was obviously nearing the end of his life, he got an adopted brother, six years old, to train by example. Another great little pet, well trained and loved a lot.
It isn't quite that straight forward in real life. I have seen many times when there was a living will or even the healthcare power of attorney where the wishes were not honored because other family members were raising all kinds of hell. It is easier (and safer) to cater to the more vociferous members of the family.
I do a lot of cancer-related writing. The headlines in the field (for many, but not all cancers) talk about the great 4 month survival advances. Ain't enough for me to worry about. If the 5 year survival ain't 40% or more, don't want to talk about it.
That's so sad.
The New York Magazine article is pretty scary because it makes it clear there's very little incentive NOT to pour on the coals and perform procedure after procedure on terminal patients. It brings in the Medicare bucks for doctors, hospitals and big Pharma so *they're* not going to stop the gravy train. It must have been pretty awful to watch your mom "dwindle" the way she did. Part of the problem is that people don't want to think about things like death, infirmity, long term care, etc. I forwarded that NYM article to a friend whose two parents are dying, one from dementia and one from pulmonary fibrosis and it's about as horrible a final act as you could ever imagine.
Another friend, 83, ended up in assisted living after a long stint in rehab after lying on the floor for three days with a broken wrist after a bad fall, unable to get up. It's amazing he survived. Though we talked often about his move to assisted living, it probably would still be just talk and would have never happened without an "incident." These are very complex and emotional issues and are very hard to consider dispassionately.
Sort of like going to a celebate Catholic priest for marriage counseling. (-"
Really? Many states have no income tax, not even 1%. NJ's tops out at 9%. So clearly the income tax is s not proportional or in line with salaries as compared to many other states. Then there are the crushing property taxes that have nothing to do with salary or income. Here, a senior citizen living on social security in a 2500 sq ft house can be paying $8K or more in real estate tax. Then you go to buy something and you're hit with a 7% sales tax.
It used to be, but the libs have turned it into hell.
This guy says California's problems have been mostly dealt with, and you say someone else is the idiot? Good grief. CA is going broke thanks to all the lib loons that have turned it into the classic socialist welfare hell.
Who the hell cares what some half-assed magazine, that bases their ratings on whatever they feel like says? Did they factor in that NJ has one of the highest income tax rates? The highest property taxes? High auto insurance rates? A 7% sales tax? Businesses that either have left the state or not expanding and already have one foot out the door? That we're sending our hard earned money to places like Camden, and Newark, so they get more per student than places like your cherished Berkley Heights and the kids 20 years and billions later are still dumb as ever? Good grief! It doesn't take much to fool some people.
Look at your property tax bill. Look at your income tax bill. Look at your 7% sales tax bill. Look at the new taxes levied on real estate sales. It's people like you that the politicians love. They take your money, piss it away, put the state $50bil in debt, and as long as you have a nice house and some dumb magazine says your town is great, you're too dumb to know that you're getting screwed.
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